Diagnostic utility of Speckle tracking Echocardiography in detection of subclinical left ventricular dysfunction in patients with Rheumatoid Arthritis

Abstract

Background: Patients with rheumatoid arthritis (RA) have a shorter life expectancy and a higher risk of cardiovascular death than the general population. Speckle tracking echocardiography may detect early myocardial dysfunction in RA patients. Aim of the work: Current study aimed at detection of early systolic & diastolic myocardial impairement in RA patients and effects of disease on left ventricular remodeling. Patients and Methods: This case control study that was conducted at cardiology department –Zagazig university hospital on 100 individuals were recruited from rheumatology & cardiology clinics during the period from August 2022 to February 2023. Patients were subdivided into two groups; Study group included 50 patients already diagnosed as Rheumatoid arthritis and Control group included 50 sex- and age-matched healthy adults. Results: There was a statistically significant positive correlation between disease duration and the age of the analyzed cases, AP4C LS, AP2C LS, AP3C LS, GLS, and PASP, but not with the other studied parameters. Global longitudinal strain (GLS) was significantly impaired compared to healthy control of the same age and sex group, rather than diastolic dysfunction, and it should be considered the first sign of subclinical cardiac dysfunction in adults. Conclusion: GLS measurement using Speckle Tracking Echocardiography (STE) is valuable and reproducible tool in detecting impairment of left ventricle systolic function in RA patients, even in the presence of normal ejection fraction. The degree of systolic function impairment is correlated to RA duration.